50 days of free full text access: “Increasing food texture and teaching chewing for a clinical case within the home setting in Australia”

Children with paediatric feeding disorders may not naturally develop typical chewing skills to eat age-appropriate food textures. There are only a handful of studies on teaching chewing, and even less for children without any chewing history. Additional research is needed on increasing food texture and chewing skills, particularly internationally in settings outside of intensive specialised interdisciplinary hospitals. A 5-year-old male with avoidant/restrictive food intake disorder (ARFID), autism spectrum disorder, iron deficiency, low weight, and history of constipation who had never chewed (not even infant dissolvables) or eaten texture other than baby food in his life participated. He had failed treatment attempts by multiple disciplines for over 4 years, including a week-long inpatient interdisciplinary feeding hospitalisation. We used a modified multiple baseline probe across food textures design. After 3 weeks of solely behaviour-analytic treatment, Junot was eating (chewing and swallowing) a full plate of regular texture portions of a variety of 109 foods from all food groups. He learned to bite off, chew, lateralise, masticate, judge, and swallow a wide variety of regular texture foods, including some meats and raw fruit and vegetables. We trained his parents to implement the protocol with high integrity. He met all 100 % of goals. Parents reported high satisfaction and social acceptability and gains were maintained to 1-year follow-up.